Caesarean Delivery in South-Western Iran: Trends and Determinants in a Community-Based Survey

OBJECTIVE: To assess trends in caesarean delivery and its associated factors in south-western Iran. SUBJECTS AND METHODS: This cross-sectional study was conducted from January 2007 to January 2010 in Fars province, Iran. All deliveries recorded in public and private hospitals were included. The Mann-Whitney U test, χ(2) test and multivariate logistic regression models were used for analysis of data. A p value less than 0.05 was considered significant. RESULTS: The rate of caesarean section for the whole sample of 139,159 increased from 51.6% in 2007 to 53.3% in 2009, which was statistically and clinically significant. The rate of caesarean delivery was significantly higher in primiparous compared to multiparous mothers. The rate increased steadily with the mother's age. The most prevalent recorded reason for caesarean delivery was maternal request. Logistic regression analysis showed that maternal age, previous abortions, underlying maternal disease, gestational age and number of living children were key contributing factors to the choice of mode of delivery. CONCLUSION: This study showed an increasing rate of caesarean delivery which should draw the attention of policymakers to factors associated with this mode of delivery.